Provider Demographics
NPI:1609034743
Name:KAPOOR, RAVI (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:RAVI
Middle Name:
Last Name:KAPOOR
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:480 13TH ST
Mailing Address - Street 2:APARTMENT 1
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-5207
Mailing Address - Country:US
Mailing Address - Phone:917-750-6452
Mailing Address - Fax:
Practice Address - Street 1:82-70 164TH STREET
Practice Address - Street 2:C/O EMERGENCY DEPARTMENT
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432
Practice Address - Country:US
Practice Address - Phone:718-883-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-27
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY239906207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine